SU1680113A1 - Method of plastic reconstruction of the anterior cruciate ligament of the knee - Google Patents

Abstract

This invention relates to medicine, namely to traumatology and orthopedics. The aim of the invention is an early functional load and a reduction in the duration of treatment due to the elimination of immobilization in the postoperative period. The method is implemented as follows: a double lavsan tape is held over the cortical platform formed in the sagittal plane of the external condyle of the femur, and the separate ends of the tape through the formed V-shaped channel in the tibial bone, followed by fixation over the cortical platform.

Description

The invention relates to medicine, namely to orthopedics and traumatology, and is intended for the treatment of injuries to the cruciate ligaments of the knee joint.

The purpose of the invention is an early functional load, and a reduction in the duration of treatment by eliminating immobilization in the postoperative period.

The method is carried out as follows.

Pain relief is common. Put a tourniquet on the thigh and a medial incision like Rauch on the inside of the knee joint opens the joint. Produced joint revision. From the inner side of the external condyle of the femur, through the anatomical attachment site of the ligament, a canal that extends to the frontal area of the femur is drilled a little above the epicondyle. 1.5 cm above the outside opening of the canal in the femur outside the cortical layer is drilled

and using a tool to form a subcortical canal, a support bone site is made in the sagittal plane.

In the tibial bone, a U-shaped bone canal is formed, opening with one hole in the anterior micomolar junction of the tibia. On the outer side of the tibia, the distance between the holes is 1.5 cm.

A large honeycomb dacron tape, 10 mm wide, 35-40 cm long, is led through one part of the tibial V-channel into the joint. From the inside of the joint, the tape harvester tape is inserted into the femoral canal and the tape is removed through the external opening of the canal. A sturdy nylon or silk thread-holder is stitched through the end of the ribbon. Lavsan tape is led back to the joint through the subcortical canal.

From the joint, the tape is guided through another part of the V-shaped channel of the tibia. The lavsan tape is tensioned and fixed with a sea knot. For convenience, the lower leg is bent at an angle of 150 °. The ends of the lavsan tape are cut off at a distance of 2.5 cm from the knot, and the remaining ends are sucked into the openings of the channels. Then other soft tissues are also stitched in layers, tightly. Antibiotics are injected into the joint. Aseptic dressing is applied to the wound. The knee joint is bandaged with a moderately tight dressing for 2 hours. The plaster splint is not applied. On the bed, using a functional bed, the leg is given a high position, and the lower leg is bent 150-160 °.

Example. Patient K., 33 years old. Complaints of instability and pain in the right knee joint. According to the patient a few years ago, a game of football, with a fixed right foot suddenly turned to the left. It was as if the dislocation of the knee joint of the right leg. The joint is swollen, treated on an outpatient basis. 5 times blockade of the knee joint of the right leg. 1 month ago, during work in the garden, a blockage of the right knee joint occurred again. The patient was referred for hospitalization.

On admission, the contours of the knee joint are smoothed, the effusion in the joint is determined. There is an atrophy of the muscles of the right thigh (2 cm). The extension of the leg is limited to 10 °, flexion is not limited. Symptom front drawer positive (13 mm). In the position of internal rotation of the tibia by 30 ° - 5 mm, with external rotation of 15 ° - 15 mm.

Diagnosis: damage to the anterior cruciate ligament and internal meniscus with a blockage of the right knee joint. Made operation. During revision of the knee joint, it was found that the anterior cruciate ligament was torn, there were only fiber residues. Internal meniscus

ragged as a handle watering can. Meniscus removed. Remnants of anterior cruciate ligament removed. A plastic anterior cruciate lavsan tape was produced according to the following method: a channel was formed in the external condyle of the femur and the internal condyle of the tibia through the anchorage of the ligament, formed for the opening on the anterior surface of the tibia, the supporting cortical areas in the sagittal plane. The wound is sewn up in layers, tightly. Aseptic dressing is applied. An additional 2 hours was applied for a moderately heavy load. Immobilization was not performed. Bracing and special exercises are scheduled for 2 days after surgery. On day 10, it is allowed to walk using crutches, not a fit to the operated limb. Stitches for 12 days. The postoperative course without complications. Before discharge, the extension of the tibia is complete, flexion to 90 °. Discharged for outpatient treatment. Appointed to continue physical therapy, massage. Long-term treatment results are rated as good.

Claims (1)

Invention Formula The method of plastics of the anterior cruciate ligament of the knee joint, by incision, formation of canals in the femoral and tibial bones, and through the canals of the implant, followed by fixation, in order to preserve early functional load and reduce the duration of treatment by eliminating immobilization in the postoperative period , in the external condyle of the femur at the external opening of the canal, a cortical anvil is formed in the sagittal plane, in the internal condyle of the tibial bone is formed the channel through the attachment point of the linkage with two outlet openings on the front surface.